Magic Valley Pain Specialists, PLLC
NPI 1003564998ActiveOrganization· Anesthesiology, Pain Medicine· Burley, ID
Anesthesiology, Pain Medicine in Burley, Idaho, registered in NPPES in March 2022. The authorized official on file is Tyler C. Roe, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003564998 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 10, 2022 |
| Last updated in NPPES | Sep 27, 2022 |
| Certified by provider | Sep 27, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology, Pain Medicine Primary | 207LP2900X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
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